If my kid left a mess like that regularly on someone's toilet, I'd be apologetic to the person and then teach her to clean up after herself privately. The fact that mom got mad makes me think she isn't doing anything to teach her daughter and that instead she think this is somehow the secretary's fault for even bringing it up.

At 10 years old, I would to talk to the girl herself. If she hears it from her mom, she's likely to be even more embarrassed. I'd be really polite and tell her your realize it's kind of out of her control, but that she should wipe down any messes she makes.

She may not be embarrassed about the messes she's making now, but as soon as kids at school realize her problem, she'll be teased endlessly. She needs to know she can clean up after herself.

I didn't grab all the quotes, but I will try to answer all the questions.

I am not actually sure how she is making the mess. It's not huge amounts, but it is generally in a few places--seat, lid, front of toilet. I would guess she waits too long or it comes on fast, because she generally runs to the bathroom.

She is a very nonchalant, open kid. I don't think making the mess would faze her, and I have seen evidence of similar in their home. BUT, her mother and her brother all have the same health issue, so it is likely not just her. I don't want to paint a picture of a poo-smeared bathroom, as I said, it is just a bit. But, still, I do think 10 years old is old enough to tidy up.

I mean, she will have this for the rest of her life, so IMO, as a mom, I would want to teach my child how to deal with it and not leave a mess behind.

Regarding the flushable wipes, we are on septic, so those are not an option, although a good idea.

Her mom is someone I count as a friend, but given her reaction to the receptionist story, and the fact that we rarely ever talk about this part of the illness, I am not eager to bring it up. Usually I just clean it, but DH is not often here. I have known her mom for about three years, and there are places we do not go, yet.

That said, if my kid was having this issue, I would want to know.

FTR, I don't think the receptionist was overly harsh about it, when she told mom. I don't believe there was anyone else present. This mom does have a tendency to perfectionalize her kids and underestimate her daughter (the baby), so I think it hit too close to home, embarrassed her and got her back up.

I would just say simply, "Please clean up after yourself. Use those wipes to clean up the toilet, floor, etc. when you are finished."

I agree with this. I would approach it gently and matter of factly with the girl first and leave the mom out of it unless it doesn't resolve.

The mom should be teaching her the life skills to clean up after herself, but she may be babying and protecting her because she is sick and if so, will likely react to you the same way she did the receptionist. So just talk to the girl discreetly and give her the tools and instruction she needs to clean up after herself.

FTR, I don't think the receptionist was overly harsh about it, when she told mom. I don't believe there was anyone else present. This mom does have a tendency to perfectionalize her kids and underestimate her daughter (the baby), so I think it hit too close to home, embarrassed her and got her back up.

I don't have any problem with the secretary bringing it up, assuming she was at least polite about it. Let's be honest, cleaning up your own kids' poo is gross. Cleaning up someone else's poo is enough to make me dry heave. I think the mom is doing her daughter a huge disservice by not teaching her to clean up after herself. If the optometrist and you have both noticed, other people will notice and she'll earn herself a really embarrassing reputation.